Provider Demographics
NPI:1801544069
Name:YUNGFLEISCH, AMANDA KAY (CNS)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:KAY
Last Name:YUNGFLEISCH
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:KAY
Other - Last Name:HYBACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1425 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1425 PORTLAND AVE BLDG 3
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3095
Practice Address - Country:US
Practice Address - Phone:585-694-7556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY667789364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care